Individual
SOUKSAKHONE PHOMMYVONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
319 S 17TH ST STE 405, OMAHA, NE 68102-2010
(402) 946-1263
Mailing address
319 S 17TH ST STE 405, OMAHA, NE 68102-2010
(402) 946-1263
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
NE
Other
Enumeration date
10/30/2025
Last updated
10/30/2025
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